Management of Vasculitis associated ANCA
Main Article Content
Keywords
ANCA-Associated Vasculitis, cyclophosphamide, rituximab, treatment
Abstract
The ANCA-associated vasculitis are chronic autoimmune diseases characterized by inflammation and destruction of small vessels that clinically result in significant morbidity and high mortality. These are several therapeutic alternatives with serious adverse effects, which have been implemented arbitrarily. The objective of the present work was to elaborate a
consensus document on therapeutic approach of this pathology. This document will allow us to treat patients on their standardizes protocol which will improve the control and the follow-up of cases. This will facilitate the evaluation of the effectiveness and safety of the therapeutic scheme.
References
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2. Fauci A, Katz P, Haynes B, Wolf S. Cyclophosphamid therapy of severe systemic necrotizing vasculitis. N Eng J Med 1979; 301: 235-238.
3. Fauci A, Haynes B, Katz P, , Wolf S.Wegener's rranulomatosis: Prospective clinical and therapeutic experience with 85 patients for 21 Years. Ann In Med 1983; 98: 76-85.
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6. Reinhold-Keller E, Schnabel A, Schmitt WH, Heller M, Beigel A, Duncker G, et al. Influence of disease manifestation and antineutrophil cytoplasmic antibody titer on the response to pulse cyclophosphamide therapy in patients with Wegener's granulomatosis. Arthritis Rheum 1994; 37: 919–24.
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8. Adu D, Pall A, Luqmani R a, Richards NT, Howie AJ, Emery P, et al. Controlled trial of pulse versus continuous prednisolone and cyclophosphamide in the treatment of systemic vasculitis. Q J Med 1997; 90: 401–9.
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11. Harper L, Morgan MD, Walsh M, Hoglund P, Westman K, Flossmann O, et al. Pulse versus daily oral cyclophosphamide for induction of remission in ANCA-associated vasculitis: long-term follow-up. Ann Rheum Dis 2012; 71: 955–60.
12. Stone JH, Merkel PA, Spiera R, Seo P, Langford C, Hoffman GS, Kallenberg CGMl. Rituximab versus cyclophosphamide for ANCA-Associated Vasculitis. N Engl J Med 2010; 363: 221-32.
13. Pagnoux C, Thomas Quéméneur T, Ninet J, Diot E, Kyndt X, de Wazieres B, Reny JL, Puechal X, le Berruyer PY. Treatment of Systemic Necrotizing Vasculitides in Patients Aged Sixty-Five Years or Older. Arthritis Rheum 2015; 67: 1117-1127
14. Stegeman CA, Tervaert JW, De Jong P, Kallenberg C . Trimethoprim–sulfamethoxazole (Co-Trimoxazole) for the prevention of relapses of Wegener’s granulomatosis. N Eng J Med; 1996; 335: 16-20.
15. Hoffman GS, Leavitt RY, Kerr GS, Fauci AS. The treatment of Wegener’s granulomatosis with glucocorticoids and methotrexate. Arthritis Rheum 1992; 35: 1322–9.
16. de Groot K, Reinhold-Keller E, Tatsis E, Paulsen J, Heller M, Nolle B, Gross Wl. Therapy for the maintenance of remission in sixty-five patients with generalized Wegener’s granulomatosis. Arthritis Rheum 1991; 36: 2052-2061.
17. Langford CA, Talar-Williams C, Barron KS, Sneller MC. A staged approach to the treatment of Wegener’s granulomatosis: Induction of remission with glucocorticoids and daily cyclophosphamide switching to methotrexate for remission maintenance. Arthritis Rheum. 1999; 42:2666–73.
18. Reinhold-Keller E, Fink COE, Herlyn K, Gross WL, Groot KDE. High rate of renal relapse in 71 patients with Wegener's granulomatosis under maintenance of remission with low-dose methotrexate. Arthritis Rheum 2002; 47: 326–332.
19. Metzler C, Fink C, Lamprecht P, Gross WL, Reinhold-Keller E. Maintenance of remission with leflunomide in Wegener’s granulomatosis. Rheumatology 2004; 43: 315–320.
20. Metzler C, Miehle N, Manger K, Groot K De, Hellmich B, Gross WL. Elevated relapse rate under oral methotrexate versus leflunomide for maintenance of remission in Wegener ’ s granulomatosis. Rheumatology 2007; 46; 1087–109.
21. Jayne D, Rasmussen N, Andrassy K, Bacon P, Tervaert JWC, Dadoniené J, et al. A randomized trial of maintenance therapy for vasculitis associated with antineutrophil cytoplasmic autoantibodies. N Engl J Med. 2003; 349: 36–44.
22. Ducroix J, Kyndt X, Lifermann F, Papo T, Lambert M, Ph D, et al. Azathioprine or methotrexate maintenance for ANCA-associated vasculitis. N Eng J Med 2008; 359: 2790-803.
23. Walsh M, Faurschou M, Berden A, Flossmann O, Bajema I, Hoglund P, et al. Long-term follow-up of cyclophosphamide compared with azathioprine for initial maintenance therapy in anca-associated vasculitis. Clin J Am Soc Nephrol. 2014; 9: 1571–6.
24. Langford CA, Talar-Williams C, Sneller MC. Mycophenolate mofetil for remission maintenance in the treatment of Wegener’s granulomatosis. Arthritis Rheum 2004; 51:278-283
25. Specks U, Merkel PA, Seo P, Spiera R, Langford CA, Hoffman GS, Kallenberg CGM, St. Clair EW, Fessler BJ. Efficacy of remission-Induction regimens for ANCA-associated vasculitis. N Engl J Med 2013;369:417-27.
26. Guillevin L, Pagnoux C, Karras A, Khouatra C, Aumaitre O, Cohen P, Maurier F, Decaux O, Ninet J, Gobert P. Rituximab versus azathioprine for maintenance in ANCA-associated vasculitis. N Eng J Med 2014; 371:1771-80.
27. Jayne DRW, Gaskin G, Rasmussen N, Abramowicz D, Ferrario F, Guillevin L, Mirapeix E, Savage CO. Randomized trial of plasma exchange or high-dosage methylprednisolone as adjunctive therapy for severe renal vasculitis. J Am Soc Nephrol 2007; 18: 2180–2188.
28. Walsh M, Catapano F, Szpirt W, Thorlund K, Bruchfeld A, Guillevin L, Haubitz M, Merkel PA, Peh C, Pusey C, Jayne D. Plasma exchange for renal vasculitis and idiopathic rapidly progressive glomerulonephritis: a metaanalysis. Am J Kidney Dis 2011, 57:566–574.
29. Walsh M, Merkel PA, Peh Chen Au, Szpirt W, Guillevin L, D Pusey C, deZoysa J, Ives N , Clark WF. Plasma exchange and glucocorticoid dosing in the treatment of anti-neutrophil cytoplasm antibody associated vasculitis (PEXIVAS): protocol for a randomized controlled trial. Trials 2013, 14:73 doi:10.1186/1745-6215-14-73.
2. Fauci A, Katz P, Haynes B, Wolf S. Cyclophosphamid therapy of severe systemic necrotizing vasculitis. N Eng J Med 1979; 301: 235-238.
3. Fauci A, Haynes B, Katz P, , Wolf S.Wegener's rranulomatosis: Prospective clinical and therapeutic experience with 85 patients for 21 Years. Ann In Med 1983; 98: 76-85.
4. Hoffman GS, Kerr GS, Leavitt RY, Hallahan CW, Lebovics RS, Travis WD, Rottem M, Fauci AS: Wegener granulomatosis: an analysis of 158 patients. Ann Intern Med 1992; 116:488-498.
5. Hoffman G, Leavitt R, Fleisher T, Minor J, Fauci A. Treatment of Wegener's granulomatosis with intermitent high-Dose intravenous yclophosphamid. Am J Med 1990; 89: 403-410.
6. Reinhold-Keller E, Schnabel A, Schmitt WH, Heller M, Beigel A, Duncker G, et al. Influence of disease manifestation and antineutrophil cytoplasmic antibody titer on the response to pulse cyclophosphamide therapy in patients with Wegener's granulomatosis. Arthritis Rheum 1994; 37: 919–24.
7. Guillevin L, Cordier JF, Lhote F, Cohen P, Jarrousse B, Royer I, et al. A prospective, multicenter, randomized trial comparing steroids and pulse cyclophosphamide versus steroids and oral cyclophosphamide in the treatment of generalized Wegener’s granulomatosis. Arthritis Rheum. 1997;40: 2187–98.
8. Adu D, Pall A, Luqmani R a, Richards NT, Howie AJ, Emery P, et al. Controlled trial of pulse versus continuous prednisolone and cyclophosphamide in the treatment of systemic vasculitis. Q J Med 1997; 90: 401–9.
9. Haubitz M, Schellong S, Gobel U, Schurek HJ, Schaumann HJ, Koch KM, Brunkhorstm R. Intravenous pulse administration of cyclophosphamide versus daily oral treatment in patients with antineutrophil cytoplasmic antibody-associated vasculitis and renal involvement a prospective, randomized study. Arthritis Rheum 1998; 41: 1835–44.
10. De Groot K, Harper L, Jayne DRW, Suarez LFF, Gregorini G, Gross WL, et al. Pulse versus daily oral cyclophosphamide for induction of remission in antineutrophil cytoplasmic antibody-associated vasculitis: A randomized trial. Ann Intern Med 2009; 150: 670–80.
11. Harper L, Morgan MD, Walsh M, Hoglund P, Westman K, Flossmann O, et al. Pulse versus daily oral cyclophosphamide for induction of remission in ANCA-associated vasculitis: long-term follow-up. Ann Rheum Dis 2012; 71: 955–60.
12. Stone JH, Merkel PA, Spiera R, Seo P, Langford C, Hoffman GS, Kallenberg CGMl. Rituximab versus cyclophosphamide for ANCA-Associated Vasculitis. N Engl J Med 2010; 363: 221-32.
13. Pagnoux C, Thomas Quéméneur T, Ninet J, Diot E, Kyndt X, de Wazieres B, Reny JL, Puechal X, le Berruyer PY. Treatment of Systemic Necrotizing Vasculitides in Patients Aged Sixty-Five Years or Older. Arthritis Rheum 2015; 67: 1117-1127
14. Stegeman CA, Tervaert JW, De Jong P, Kallenberg C . Trimethoprim–sulfamethoxazole (Co-Trimoxazole) for the prevention of relapses of Wegener’s granulomatosis. N Eng J Med; 1996; 335: 16-20.
15. Hoffman GS, Leavitt RY, Kerr GS, Fauci AS. The treatment of Wegener’s granulomatosis with glucocorticoids and methotrexate. Arthritis Rheum 1992; 35: 1322–9.
16. de Groot K, Reinhold-Keller E, Tatsis E, Paulsen J, Heller M, Nolle B, Gross Wl. Therapy for the maintenance of remission in sixty-five patients with generalized Wegener’s granulomatosis. Arthritis Rheum 1991; 36: 2052-2061.
17. Langford CA, Talar-Williams C, Barron KS, Sneller MC. A staged approach to the treatment of Wegener’s granulomatosis: Induction of remission with glucocorticoids and daily cyclophosphamide switching to methotrexate for remission maintenance. Arthritis Rheum. 1999; 42:2666–73.
18. Reinhold-Keller E, Fink COE, Herlyn K, Gross WL, Groot KDE. High rate of renal relapse in 71 patients with Wegener's granulomatosis under maintenance of remission with low-dose methotrexate. Arthritis Rheum 2002; 47: 326–332.
19. Metzler C, Fink C, Lamprecht P, Gross WL, Reinhold-Keller E. Maintenance of remission with leflunomide in Wegener’s granulomatosis. Rheumatology 2004; 43: 315–320.
20. Metzler C, Miehle N, Manger K, Groot K De, Hellmich B, Gross WL. Elevated relapse rate under oral methotrexate versus leflunomide for maintenance of remission in Wegener ’ s granulomatosis. Rheumatology 2007; 46; 1087–109.
21. Jayne D, Rasmussen N, Andrassy K, Bacon P, Tervaert JWC, Dadoniené J, et al. A randomized trial of maintenance therapy for vasculitis associated with antineutrophil cytoplasmic autoantibodies. N Engl J Med. 2003; 349: 36–44.
22. Ducroix J, Kyndt X, Lifermann F, Papo T, Lambert M, Ph D, et al. Azathioprine or methotrexate maintenance for ANCA-associated vasculitis. N Eng J Med 2008; 359: 2790-803.
23. Walsh M, Faurschou M, Berden A, Flossmann O, Bajema I, Hoglund P, et al. Long-term follow-up of cyclophosphamide compared with azathioprine for initial maintenance therapy in anca-associated vasculitis. Clin J Am Soc Nephrol. 2014; 9: 1571–6.
24. Langford CA, Talar-Williams C, Sneller MC. Mycophenolate mofetil for remission maintenance in the treatment of Wegener’s granulomatosis. Arthritis Rheum 2004; 51:278-283
25. Specks U, Merkel PA, Seo P, Spiera R, Langford CA, Hoffman GS, Kallenberg CGM, St. Clair EW, Fessler BJ. Efficacy of remission-Induction regimens for ANCA-associated vasculitis. N Engl J Med 2013;369:417-27.
26. Guillevin L, Pagnoux C, Karras A, Khouatra C, Aumaitre O, Cohen P, Maurier F, Decaux O, Ninet J, Gobert P. Rituximab versus azathioprine for maintenance in ANCA-associated vasculitis. N Eng J Med 2014; 371:1771-80.
27. Jayne DRW, Gaskin G, Rasmussen N, Abramowicz D, Ferrario F, Guillevin L, Mirapeix E, Savage CO. Randomized trial of plasma exchange or high-dosage methylprednisolone as adjunctive therapy for severe renal vasculitis. J Am Soc Nephrol 2007; 18: 2180–2188.
28. Walsh M, Catapano F, Szpirt W, Thorlund K, Bruchfeld A, Guillevin L, Haubitz M, Merkel PA, Peh C, Pusey C, Jayne D. Plasma exchange for renal vasculitis and idiopathic rapidly progressive glomerulonephritis: a metaanalysis. Am J Kidney Dis 2011, 57:566–574.
29. Walsh M, Merkel PA, Peh Chen Au, Szpirt W, Guillevin L, D Pusey C, deZoysa J, Ives N , Clark WF. Plasma exchange and glucocorticoid dosing in the treatment of anti-neutrophil cytoplasm antibody associated vasculitis (PEXIVAS): protocol for a randomized controlled trial. Trials 2013, 14:73 doi:10.1186/1745-6215-14-73.